Montagna Symposium on the Biology of the Skin
Skamania Lodge
Sunday October 13, 2013

By Guest Bloggger Sancy Leachman, MD, PhD

Welcome to the final day of the Montagna Symposium on the Biology of the Skin 2013. The dinner speaker last night was John Parrish (in absentia via video), complemented by symposium co-leaders Barbara Gilchrest, Rox Anderson, and Steve Jacques. It was powerful. John took us through a tour of his adventures in the development of photo-related innovations, from the development of effective sunscreens to therapeutic lasers, and he shared social context along the way. The sustained level of energy and impact he has brought to our field is remarkable. What was clear is that he has been simultaneously driven and humbled by his role as an innovator in dermatology; and the level of intensity he communicated seemed to be fueled by the success he had in making a meaningful contribution for patients. It was also clear that he actively selected important and interesting problems to solve. The video resonated with so many in the audience because we glimpsed the opportunity to apply similar principles to our own work with the possibility of making a difference in the pain and suffering of patients. Our challenge, and one that was tackled in the final session of the meeting (Provocative Problems and Questions), is to harness the energy of the best and brightest minds in our field toward a unified vision to benefit our patients.

Of the provocative presentations, one that struck a chord with me was by Richard Weller, who suggested that despite our understanding that UV radiation causes skin cancer, there is no definitive data to prove that it shortens lifespan. In fact, exposure to UVA may lead to NO2 and NO3 release by the skin that could lower blood pressure and extend life. The presentation of his data and the lively discussion surrounding the pros and cons of sun exposure that ensued was invigorating. It was a fabulous example of the power of academic discourse, where opposing points of view can be clearly articulated and critiqued. Dr. Parrish’s presentation on the previous evening emphasized skepticism by the dermatology community when he first presented data demonstrating the beneficial effects of UV radiation on psoriatic skin. I can imagine this being similar to the skepticism that Dr. Weller experienced today.

Additional lively discourse occurred around the role of business in dermatology and the development of partnerships between industry and academia during the last session in the conference. At the time when Dr. Parrish completed his studies, there was little funding available for clinical trials from the NIH, but there was more support available from the hospital and discretionary clinical income. Now, both NIH funding and clinical revenue are diminishing, and to continue to support innovation and clinical trials for the benefit of our patients, it is going to be necessary to identify additional support, perhaps through industrial partnerships and patient-based philanthropy. Future dermatologic advances must be driven by innovation and the development of devices and treatments that create value, that help make our patients better.

These and other topics will be continued and extended at next year’s Montagna Symposium on the Biology of the Skin on Aging of the Skin to be held at the Salishan Resort on the Oregon Coast, Oct. 9-13, 2014. Don’t miss it!